HomeMy WebLinkAbout33784-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34040 Date: 10/27/09
THIS C~u(TIFIES that the building ALTEP~ATIONS
Location of Property: 1390 ORIOLE DR SOUTROLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 6 Lot 15.40
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 25, 2008 pursuant to which
Building Permit NO. 33784-Z dated APRIL 3, 2008
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is KITCHEN RENOVATION AMD CENTRAL AIR CONDITIONING IN AM EXISTING ONE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to RICHARD HOM
of the aforesaid building.
(OWNER)
S~FFOLK COUI~TYDEP~/~T~T OF ~]~%LTHAPPRO~L N/A
EI~C~ICAL ~TIFIC3%~ NO. 08-7862 10/27/08
~L~ERS c~KTIFICATION Da'r~ 01/21/09
RICHARD HOM
~zed~
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the lbllowing:
A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy- $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction:
Location of Property:
Date. ,c/a6 loci
Old or Pre-existing Building: (check one)
House No. Street
Owner or Owners of Property: ~ t t_ ,q.q ~.
f
Suffolk County Tax Map No 1000, Section
Hamlet
Block OOo/o Lot ors-. 05//3
Subdivision
Permit No. ,5 _~ -t~' q
Health Dept. Approval:
Date of Permit.
Filed Map. Lot:
~'/3/o ~" Applicant:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ .aS'~ --
3 /
Final Certificate:
,,/ (check one)
Applicant Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED}
PE~AMIT NO. 33784 Z Date APRIL 3, 2008
Permission is hereby granted to:
RICHARD HOM
1390 ORIOLE DRIVE
SOUTHOLD,NY 11971
for :
INSTALLATION OF A CENTRAL AIR CONDITIONING SYSTEM AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 055
pursuant to application dated MARCH
Building Inspector to expire on OCTOBER
1390 ORIOLE DR SOUTHOLD
Block 0006 Lot No. 015.040
25, 2008 and approved by the
3, 2009.
Fee $ 200.00
Authorized Signature
Rev. 5/8/02
ORIGINAL
BLDG. DEPT.
TOWN OF SOUT~OLO
chen Remodeling for 1390 Oriole Drive, Southold
Contractor indicated that PVC pipe was used to reconnect pipes, and that no soldering was used in any
pipe connections in the kitchen remodeling.
Electrical Inspectors, Inc.
308 East Meadow Avenue
East Meadow, NY 11554
Office: (516) 794-0400 (631)396-7474
Fax: (516) 794-5854
Website: www.elec~calinspectors.com
Email: info~electricalinspecmrs.com
Mail To:
East County Electric, Inc.
William Oster/Bruce Oster
PO Box 2620
Aqueboque, NY 11931
License#: 1005E
Certificate Number: 08-7862
Municipality: Southold, Town Of
Inspector: 124
lssue Date: I0/27/200~/~
Property Address:
Hom
1390 Oriole Drive~,,,.
Southold,
ELECTRICAL A P P Rf / .) 0 VA R TIFI CA TE
AREAS LISTED BELOW ARE APPR/OyE ~/BY INSPECTION
Y/ATIONAL
ELECTRIC
CODE
No visual defects were found for the elect~cal inspection pn~ No on~'bv~ i~..unsatisfacto~y conditions w~re found in the areas
herein below only. '~ ?
Residential Inspection
Central J/C Units
2-30AmpA/CCondensors, 2-2OAmpA/Cy~ /
Duplicate Originab'MH 11/14/08//]/
Richard M, Bivone
President
Philip F. Goehrin8
Chief Electrical Inspector
Not valid unless signed by an
/ v
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
~FINAL
[ ] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
REMARKS:
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]RRB RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
REMARKS:
-
INSPECTOR
DATE
FmLD LNSPECTION REPORT
FOL~Wl)ATION (IST)
FO~DATION (ZND)
ROUGH F~G &
PL~G
[NSL~ATION PER N. Y.
STATE ENERGY CODE
F~
~DITION~ COUNTS
TOWN OF SOUTHOLI5
BUILDING DEPAilTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined ~l(/fl ,20 ~
Approved ~/.~ , 20D~
Disapproved a/c
Expiration /0/.3, 20 O]
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying'?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form
Contact:
Mailto:
Phone:
· Build'lng Inspector
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
,20o '
a. Th~s application MU~T~e ~ompletely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets ofplaris; accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced belbre issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not beeu completed within 18 months from such date. If no zoning amendrucuts or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suftblk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
USE IS UN,.AWF
(Signature of applicant or name, ifa corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
If applicant is a corporation, signature of duly/l~_~lt~$¢,t ' ~>fficer: - ~' .~c '~
,, ' 71' 7HE REQU!i i ?i~ Oi: /HE
(Name and title of corporate officer) C :DES OF NEVV r,,): k SI'ATE.
Builders License No.
Plumbers License No. 3'~r7- P
Electricians License No. 5-~ t_q-F
Other Trade's License No.
UNDERWRFERS CERllFIOATE
(As on the tax roll or latest
ALL. CCd91 J '.:
Location of land on which proposed work will be done:
Op, ole_
L 'ST
*' :' ,, ~:FTHE
RE"~UfR;. 'E 4iS" -
......,, ;, .C:2 OF NEW
Y~* K ST,A~Z NOT - .j' ". ,. ¢ ,qLb FOR
. B~iGN OR CO~$oT.~uCT,OJ ERRORS.
House Number Street
County Tax Map No. 1000 Section
Subdivision
Hamlet
Lot Ot..q'. oqo
Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~,~s~--b_ o~e---~,,,&,i
b. Intended use and occupancy ?c,~ o~-~,~l~
3. Nature of work (check which applicable): New Building_ Addition Alteration
Repair Removal Demolition Other Work ee~(
~ ~ ~,~ ~e ~o~ ~ ~ ~o~ ~ 0 ~'~ : *~ ~t ~3~oq (~h~3(Descnpnon)
4. Estimated Cost q/~, o~ Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units 5'~,~ Number of dwelling units on each floor
If garage, number of cars ~
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear -,o .ct
Depth ~,-/-5o ~c-~.
Dimensions of same structure with alterations or additions: Front '7og~ Rear -~o~t
Depth ~-q'-3ogt Height. Number of Stories
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
to/ti
9. Size of lot: Front /~1,~ -Cfi.. Rear /'~30,t:'~ .Depth
10. Date of Purchase /~-//?/o '7
Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~/
13. Will lot be re-graded? YES __ NO ,/ Will excess fill be removed from premises? YES NO
14. Names of Owner of premises 'Rt¢~ca4~l~ '~ Address ~,,ta.,o,,~ , *,,~ tt,gto Phone
Name of Architect Address Phone No
Name of Contractor b, lic O,q~o,. '~,,.o,& K, itc,3 Address '70* do,,,,,-¢l A,~. Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES__ NO ,/
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO J
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES__
· IF YES, PROVIDE A COPY.
NO ,/
STATE OF NEW YORK)
SS:
COUNTY OF~
~ ~C ~4 ~l- R B C do ~A being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the O{l )F)~F-
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this
c::Q ~ day of f'~ ~ 20 0</5.-
(~ N~aw Pu~l~ ~~~ Si~ature of Applicant
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24.DISHVV
L~/1536L[
i
54" -- - 39" -
; All.d,mems,o~.~ ~s~e des, .gn~. ,o. ns g,ven are] I TI lis is a~n original design and must not be I I~signcd: 1/12/2008
subject to verification on Job site and ] released or copied unless appfieable fee[ ]Printed: 1/31/2008
adjustment to fit job conditions. ] ha~ been paid or job ordt~c pla '~xl.
--1
ORIOLE
DRIVE
A----105.91
TIE=330.4
GARAGE
wOOD FRAME
RESIDENCE
WOOD OECK
W~'O RAILING
CELLAR
ENTR,
8/3' 10 '07"W
N/F CODAN
150. I2'
SURVEY OF
LOT 57
MAPOF HIGHPOINT MEADOWS
SECTION 'PgO
SITUAT£
SOUTHOLD, TOWN OF SOUTHOLD
SUFFOLK' COUNTY, N.Y'.
FM# 981 !
DATE EILED MARCH 19, 1990
1000-055--06-075.40
SURVEYED FOR: RICHARD HOM
PATRICIA LoRIVIERE-HOM
SURVEYED: 2 OCTOBER 2007
LOT ,37
MAP OF HIGHPOINT MEADOWS
SECTION TWO
SITUATE
SOUTHOLD, TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
DATE F~L£D MARCH 19, 1990
TM// 1000-055-06-015.40
GUARANTEED TO:
RICHARD HOM
PATRICIA LoRIVIERE-HOM
COMMONWEALTH LAND TITLE /NS. CO.
BETHPAGE FEDEERAL CREDIT UNION
SURVEYED FOR: RICHARD HOM
PATRICIA LoRIVIERE-HOM
SURVEYED: 2 OCTOBER 2007
SCALE 1"= 30"
AREA = 21,059 S.F.
OR
0.485 ACRES
SURVEYED BY
STANLEY d. ISAXSEN, dR.
P.O. BOX 294
~YsffNL~cE'~ ~. 4~273 07R'/c, z6